Letter | Published:

A functional neuroanatomy of hallucinations in schizophrenia

Nature volume 378, pages 176179 (09 November 1995) | Download Citation

Subjects

Abstract

HALLUCINATIONS, perceptions in the absence of external stimuli, are prominent among the core symptoms of schizophrenia. The neural correlates of these brief, involuntary experiences are not well understood, and have not been imaged selectively. We have used new positron emission tomography (PET) methods1,2 to study the brain state associated with the occurrence of hallucinations in six schizophrenic patients. Here we present a group study of five patients with classic auditory verbal hallucinations despite medication, demonstrating activations in subcortical nuclei (thalamic, stri-atal), limbic structures (especially hippocampus), and paralimbic regions (parahippocampal and cingulate gyri, as well as orbito-frontal cortex). We also present a case study of a unique, drug-naive patient with visual as well as auditory verbal hallucinations, demonstrating activations in visual and auditory/linguistic association cortices as part of a distributed cortical–subcortical network. Activity in deep brain structures, identified with group analysis, may generate or modulate hallucinations, and the particular neo-cortical regions entrained in individual patients may affect their specific perceptual content. The interaction of these distributed neural systems provides a biological basis for the bizarre reports of schizophrenic patients.

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

References

  1. 1.

    et al. J. cereb. Blood Flow Metab. 13, 617–629 (1993).

  2. 2.

    et al. J. cereb. Blood Flow Metab. 14, 771–782 (1994).

  3. 3.

    et al. Hum. Brain Mapping 2, 189–210 (1995).

  4. 4.

    Schizophr. Bull. 19, 431–445 (1993).

  5. 5.

    , , & Schizophr. Res. 11, 225–38 (1994).

  6. 6.

    et al. Science 266, 294–298 (1994).

  7. 7.

    & Neuroscience 44, 521–535 (1991).

  8. 8.

    The Psychoses of Epilepsy (Raven, New York, 1991).

  9. 9.

    , & Biol Psychiat. 30, 383–400 (1991).

  10. 10.

    & Biol. Psychiat. 37, 667 (1995).

  11. 11.

    , & Brain 115, 367–382 (1992).

  12. 12.

    et al. J. Neurosci. 11, 641–649 (1991).

  13. 13.

    , , & Brain 116, 1293–1302 (1994).

  14. 14.

    Trends Neurosci. 12, 395–399 (1989).

  15. 15.

    et al. Hum. Brain Mapping (Suppl.) 1, 417 (1995).

  16. 16.

    et al. Psychol. Med. (in the press).

  17. 17.

    et al. in Biology of Schizophrenia and Affective Disease (ed. Watson, S. J.) (Raven, New York) (in the press).

  18. 18.

    et al. J. Neuropsychiat. clin. Neurosci. 6, 419–427 (1994).

  19. 19.

    in Principles of Behavioral Neurology (ed. Mesulam, M. M.) 1–58 (Davis, Philadelphia, 1985).

  20. 20.

    et al. Am. J. Psychiat. 144, 151–158 (1987).

  21. 21.

    et al. Biol. Psychiat. 25, 835–851 (1989).

  22. 22.

    et al. Br. J. Psychiat. 157, 562–570 (1990).

  23. 23.

    et al. Am. J. Psychiat. 149, 1062–1069 (1992).

  24. 24.

    et al. Clin. nucl. Med. 13, 53–55 (1988).

  25. 25.

    et al. Clin. nucl. Med. 14, 319–321 (1989).

  26. 26.

    et al. Eur. Neurol. 24, 176–181 (1985).

  27. 27.

    et al. Comp. Psychiat. 30, 99–108 (1989).

  28. 28.

    , & Lancet 342, 703–706 (1993).

  29. 29.

    & Co-Planar Stereotaxic Atlas of the Human Brain (Thieme, Stuttgart, 1989).

  30. 30.

    , & J. Comput. Assist. Tomogr. 17, 536–546 (1993).

Download references

Author information

Affiliations

  1. MRC Cyclotron Unit, Institute of Neurology, Hammersmith Hospital, Ducane Road, London W12 ONN, UK

    • D. A. Silbersweig
    • , E. Stern
    • , C. Frith
    • , C. Cahill
    • , Sylke Grootoonk
    • , J. Seaward
    • , S. E. Chua
    • , L. Schnorr
    • , T. Jones
    •  & R. S. J. Frackowiak
  2. Wellcome Department of Cognitive Neurology, Institute of Neurology, Hammersmith Hospital, Ducane Road, London W12 ONN, UK

    • D. A. Silbersweig
    • , E. Stern
    • , C. Frith
    • , A. Holmes
    • , Sylke Grootoonk
    •  & R. S. J. Frackowiak
  3. Functional Neuroimaging Laboratory, Box 171, The New York Hospital-Cornell Medical Center, 525 East 68th Street, New York, New York 10021, USA

    • D. A. Silbersweig
    • , E. Stern
    •  & R. S. J. Frackowiak
  4. Fulbourn Hospital, Cambridge Road, Fulbourn, CB1 5EF, UK

    • P. McKenna

Authors

  1. Search for D. A. Silbersweig in:

  2. Search for E. Stern in:

  3. Search for C. Frith in:

  4. Search for C. Cahill in:

  5. Search for A. Holmes in:

  6. Search for Sylke Grootoonk in:

  7. Search for J. Seaward in:

  8. Search for P. McKenna in:

  9. Search for S. E. Chua in:

  10. Search for L. Schnorr in:

  11. Search for T. Jones in:

  12. Search for R. S. J. Frackowiak in:

About this article

Publication history

Received

Accepted

Published

DOI

https://doi.org/10.1038/378176a0

Further reading

Comments

By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.